AAA Flashcards
During an assessment of a patient’s abdomen, a pulsating abdominal mass is noted by the healthcare provider. Which of the following should be the healthcare provider’s next action?
A Measure the abdominal circumference
B Ask the patient to perform a Valsalva maneuver
C Obtain a bladder scan
D Assess femoral pulses
D
An unconscious patient arrives at the emergency department. Periumbilical (Cullen’s sign) and flank ecchymosis (Grey Turner’s sign) is noted , and a ruptured abdominal aortic aneurysm (AAA) is suspected. Which of these additional assessment findings will the healthcare provider anticipate?
(Choice A) Expiratory wheezes
(Choice B) Pinpoint pupils
(Choice C) Decorticate posturing
(Choice D) Pale, clammy skin
D
The healthcare provider is assessing a patient who has a been diagnosed with an abdominal aortic aneurysm (AAA). Which assessment finding is an indication that the aneurysm is expanding?
(Choice A) Hoarseness and cough
(Choice B) A report of lower back pain
(Choice C) Anginal pain
(Choice D) Dysphasia
B
The healthcare provider is reviewing risk factors for the development of an abdominal aortic aneurysm (AAA). Which of these inherited disorders in a patient’s history is most likely related to the development of an AAA?
(Choice A) Trisomy 21
(Choice B) Klinefelter syndrome
(Choice C) Marfan syndrome
(Choice D) Sickle cell anemia
C
The development of an AAA is associated with connective tissue disorders such as Marfan syndrome. Marfan syndrome results in connective tissue deficiency and ineffective collagen cross-linking, resulting in a weakened aorta which is prone to aneurysm or dissection.
A patient is diagnosed with an abdominal aortic aneurysm (AAA). Which of the patient’s vital signs will be a priority for the healthcare provider to monitor?
(Choice A) Core temperature
(Choice B) Respiratory rate
(Choice C) Blood pressure
(Choice D) Pulse rate
C
While assessing the peripheral circulation of a patient with a diagnosis of an abdominal aortic aneurysm (AAA), the healthcare provider notes patchy mottling of the feet and toes. Pedal pulses are present. How should the healthcare provider interpret these findings?
(Choice A) The patient’s peripheral artery disease has progressed
(Choice B) The patient has a history of Raynaud Phenomenon
(Choice C) This is evidence of digital clubbing secondary to pulmonary disease
(Choice D) The patient’s digital arteries have become occluded
D
Which of these interventions should be the highest priority when caring for a patient with suspected abdominal aortic aneurysm (AAA) rupture?
(Choice A) Increasing cardiac contractility
(Choice B) Inserting an indwelling urinary catheter
(Choice C) Obtaining a STAT electrocardiogram (EKG)
(Choice D) Maintaining blood pressure
D
The healthcare provider is evaluating effectiveness of discharge teaching for a male patient following an abdominal aortic aneurysm (AAA) repair. Which of these statements made by the patient indicates the teaching has been successful?
(Choice A) “I should avoid being around people who are sick.”
(Choice B) “I’ll be able to resume my usual work-out at the gym.”
(Choice C) “I will take my radial pulse each day and keep track of the rate.”
(Choice D) “It’s possible that I may experience some sexual dysfunction.”
D
While recovering from an endovascular aortic repair (EVAR) of an abdominal aortic aneurysm (AAA), the patient experiences numbness and tingling in the feet. What is the healthcare provider’s priority action?
(Choice A) Gently massage the legs and feet
(Choice B) Palpate the pedal pulses
(Choice C) Apply warm compresses to the feet
(Choice D) Assist the patient to ambulate
B
The healthcare provider is assessing a patient with a diagnosis of an abdominal aneurysm (AAA). Which of these assessment findings will the healthcare provider anticipate?
(Choice A) A friction rub auscultated in the right upper abdominal quadrant
(Choice B) A venous hum auscultated in the epigastric area.
(Choice C) Tenderness felt over the costovertebral angle (CVA)
(Choice D) A bruit auscultated over the periumbilical area
D
The nurse is admitting a 68-year-old preoperative patient with a suspected abdominal aortic aneurysm (AAA). The medication history reveals that the patient has been taking warfarin (Coumadin) on a daily basis. Based on this history and the patient’s admission diagnosis, the nurse should prepare to administer which medication?
A) Vitamin K
B) Cobalamin
C) Heparin sodium
D) Protamine sulfate
A) Vitamin K
Coumadin is a Vitamin K antagonist anticoagulant that could cause excessive bleeding during surgery if clotting times are not corrected before surgery. For this reason, vitamin K is given as the antidote for warfarin (Coumadin).
What medications should the nurse expect to include in the teaching plan to decrease the risk of cardiovascular events and death for PAD patients (select all that apply)?
A) Ramipril (Altace)
B) Cilostazol (Pletal)
C) Simvastatin (Zocor)
D) Clopidogrel (Plavix)
E) Warfarin (Coumadin)
F) Aspirin (acetylsalicylic acid)
A) Ramipril (Altace)
C) Simvastatin (Zocor)
F) Aspirin (acetylsalicylic acid)
Angiotensin-converting enzyme inhibitors (e.g., ramipril [Altace]) are used to control hypertension. Statins (e.g., simvastatin [Zocor]) are used for lipid management. Aspirin is used as an antiplatelet agent. Cilostazol (Pletal) is used for intermittent claudication, but it does not reduce CVD morbidity and mortality risks. Clopidogrel may be used if the patient cannot tolerate aspirin. Anticoagulants (e.g., warfarin [Coumadin]) are not recommended to prevent CVD events in PAD patients.
A male patient was admitted for a possible ruptured aortic aneurysm, but had no back pain. Ten minutes later his assessment includes the following: sinus tachycardia at 138, BP palpable at 65 mm Hg, increasing waist circumference, and no urine output. How should the nurse interpret this assessment about the patient’s aneurysm?
A) Tamponade will soon occur.
B) The renal arteries are involved.
C) Perfusion to the legs is impaired.
D) He is bleeding into the abdomen.
D) He is bleeding into the abdomen.
The lack of back pain indicates the patient is most likely exsanguinating into the abdominal space, and the bleeding is likely to continue without surgical repair. A blockade of the blood flow will not occur in the abdominal space as it would in the retroperitoneal space where surrounding anatomic structures may control the bleeding. The lack of urine output does not indicate renal artery involvement, but that the bleeding is occurring above the renal arteries, which decreases the blood flow to the kidneys. There is no assessment data indicating decreased perfusion to the legs.
